Publish date: 19 April 2022
From 1 April 2022 the trust embarked on a ‘soft launch’ of the Patient Safety Incident Response Framework (PSIRF); this will replace the Serious Incident Framework (SIF).
The soft launch will be unique for each organisation. The soft launch for Mersey Care will mean as an organisation we will start to pull together our patient safety incident response plan (PSIRP). The development of MCFT PSIRP will involve several elements, including identification of the local risks the Trust will report on, we will pull from resources both internal and external to the Trust to help develop this list to ensure that we are identifying incidents where learning can be made. We will look to understand the current resources available within the Trust and where, if any, the shortfalls lay. As part of the soft launch the Trust will also develop the role of patient safety partner, this role will be vital in assist the Trust in learning from patient safety events.
The reactive and prescriptive thresholds for serious incident reporting are to be replaced with a broader, more proactive, and risk-based approach. There is also no distinction between incidents and ‘serious incidents’.
Some incidents, where we feel there is significant organisational learning to be gained, will qualify for a Patient Safety Incident Investigation (PSII). Our PSIRP will outline the number and type of PSIIs we are going to complete as well as how we will ensure sufficient resources are available to support the plan. The numbers of investigations we will undertake is therefore going to reduce, allowing us to focus on delivery of the lessons learnt from previous investigations.
Those of you involved in incident investigation will also be relieved to hear there will be a shift away from root cause analysis (RCA), which is well known for being time-consuming and bureaucratic. Replacing RCA will be a suite of system-based investigation methodologies which will better support the identification of the deep-seated causal factors of incidents.
Our plan will also outline the other, alternative proportionate responses for example: Datix investigations, case note review; ‘being open’ conversations and audit.
The PSIRF signals a new era for the management of incidents in the NHS, providing an effective and compassionate patient safety reporting, learning and improvement system, underpinned by openness and transparency, just culture and continuous learning and improvement.
For more information on our PSIRP and how the PSIRF will change our response to patient safety incidents please see refer to the PSIRF page within YourSpace or direct your emails to PSIRFenquiries